Thank you,
Chairman Coffman, Ranking Member Kuster, and Members of the Committee for
today’s hearing and for this opportunity to appear before you.

I’m Anthony Hardie, a 1991 Gulf War and Somalia veteran, and Director of
Veterans for Common Sense.I’ve provided
testimony on several previous occasions, but today is especially notable.

Twenty-five
years ago tonight, we launched the ground war of Operation Desert Storm and successfully
liberated Kuwait.Tonight, I would like
us to remember and honor of the nearly 300 of our fellow Gulf War men and women
who made the ultimate sacrifice.I would
also like us to remember and honor the nearly 700,000 veterans of the Persian
Gulf War, who under the direction of our military leaders led our broad
international Coalition to decisive military victory.

“Our” war was
relatively short: just a five-month buildup, and then a six-week war before a
swift military victory.However, you’ve
heard my personal experiences before, and you’ve heard the stories of many
other Gulf War veterans, and as this Committee knows, between one-fourth and
one-third of us returned home with serious and debilitating health issues now
known as Gulf War Illness.And, we faced
a new battle, a much longer war – a war to obtain effective healthcare and VA
assistance from entrenched government officials who seemed intent on proving
there was nothing wrong with so many Gulf War veterans, that it was all in our
heads, just stress, the same as after every war.

1998 PERSIAN GULF WAR VETERANS LEGISLATION

It took almost
eight years after the war before our major legislative victory, with the
enactment of the Persian Gulf War Veterans
Act of 1998 (Title XVI, PL 105-277) and the Veterans Programs Enhancement Act of 1998 (PL 105-368, Title
I—“Provisions Relating to Veterans of Persian Gulf War and Future Conflicts”) –
two landmark bills that set the framework for Gulf War veterans’ healthcare,
research, and disability benefits.

For those of us
involved in fighting for the creation and enactment of these laws, they seemed clear
and straightforward, with a comprehensive, statutorily-mandated plan that would
guarantee research, treatments, appropriate benefits, and help ensure that lessons
learned from our experiences would result in never again allowing what happened
to us to happen to future generations of warriors.

The legislation included a long list of known Gulf War exposures.VA was to presume our exposure to all of
these, and then, with the assistance of the National Academy of Sciences (NAS),
evaluate each exposure for associated adverse health outcomes in humans and
animals.In turn, the VA Secretary would
consider the reports by the NAS’s Institute of Medicine (IOM), “and all other
sound medical and scientific information and analyses available,” and make
determinations granting presumptive conditions.There was a new guarantee of VA health care. There would also be a new national
center for the study of war-related illnesses and post-deployment health
issues, which would conduct and promote research regarding their etiologies,
diagnosis, treatment, and prevention and promote the development of appropriate
health policies, including monitoring, medical recordkeeping, risk
communication, and use of new technologies. There was to be an effective methodology
for treatment development and evaluation, a medical education curriculum, and outreach
to Gulf War veterans.Research findings
were to be thoroughly publicized.To
ensure the federal government’s proposed research studies, plans, and strategies
stayed focused and on track, VA was to appoint a research advisory committee
that included Gulf War veterans – presumably those who were ill and affected –
and their representatives.

Instead, we
learned that enactment of those laws was just another battle in our long war.

From the
beginning, VA officials fought against implementing these laws, dragging their
feet and upending their implementation.

The creation of
the “national center” never met Gulf War veterans’ expectations.The long list of toxic exposures never led to
a single exposure-related presumption.Many of the exposures were never even considered, and those that were didn’t
include evaluation of the health effects in laboratory animals with respect to
likely health outcomes in ill Gulf War veterans.The research never led to effective,
evidence-based treatments and indeed had little treatment focus until after
Congress established a treatment-focused research program outside of VA.

And only after
significant pressure and a change in Administrations did VA finally establish
the research advisory committee (RAC) – more than three years after the
statutorily mandated January 1, 1999 deadline.But, VA then systematically ignored its recommendations, and diminished
its findings.When it sharpened its
criticism of VA’s failures related to Gulf War veterans, VA staff led measures
to substantially diminish its charter and discharge all of its members.

As a last ditch
effort to call attention to VA’s myriad failures of Gulf War veterans, I led
Gulf War veterans’ resignations from the RAC in June 2013.Subsequently, the House unanimously passed
legislation that would have restored and enhanced the research advisory
committee and helped Gulf War veterans, for which we remain grateful.Unfortunately, the Senate failed to take action
and the bill died in Congress.

I served on the
RAC for eight years and remain deeply impressed by the broad knowledge, demonstrated
commitment, and impressive accomplishments aimed at solving Gulf War Illness of
the scientists and doctors who served on and appeared before the panel.And, I remain proud of the work of dozens of
researchers and Gulf War veteran stakeholders who came together to produce a
comprehensive strategic plan aimed at solving Gulf War Illness, identifying
other health conditions in Gulf War veterans, and helping achieve the laudable
goals of the 1998 Gulf War legislation.Sadly for ill Gulf War veterans, nearly all of the provisions of that
research strategic plan remain unimplemented, like so much of the rest of VA’s half
steps in implementing and achieving the goals of the 1998 legislation.

And in a 2013
hearing by this Committee, we learned from a top VA
epidemiologist-turned-whistleblower many of the sordid details of officials
within the VA’s Office of Public Health who failed to ask the right questions
in research that would lead to showing the real post-deployment health outcomes
for Gulf War and other veterans, and often obfuscated research findings when
they showed results that might show significant health outcomes.

That leads us
to today.

NEW IOM REPORT

Two weeks ago,
the NAS’s Institute of Medicine (IOM) released its newest and supposedly final
report in the extended, “Gulf War and Health,” series under VA contract as directed
by the 1998 legislation.Entitled, “Gulf
War and Health, Volume 10: Update of Health Effects of Serving in the Gulf War,
2016,” it is highly problematic. While IOM’s Volume 10 acknowledged that Gulf
War illness is the signature adverse health outcome of the 1991 Gulf War – a
fact that has been known by Gulf War veterans since the early 1990s and
definitively shown by science since at least 2004 – its research and treatment
recommendations range from disappointing to potentially damaging to the health
and lives of Gulf War veterans with Gulf War Illness.

IOM’s
Volume 10 recommends no further research using animal models of Gulf War toxic
exposures (p. 251).While the IOM Volume
10 panel acknowledged that an
animal model would be advantageous for identifying and evaluating Gulf War
Illness treatment strategies, they then suggested that the precise frequency,
duration, dose of Gulf War exposures must be known in order to do so.This amounts to
"rolling up the sidewalk" on this promising avenue of Gulf War
Illness research, just when it is beginning to unravel the underlying
biological mechanisms of Gulf War illness and point to treatment targets.

Past
IOM review panels have been limited by VA’s systemic failures in monitoring,
assessing, and reporting the incidence and prevalence of health symptoms and
diagnosed diseases in Gulf War (and other cohorts of) veterans.The IOM Volume 10 panel was similarly limited.As one example, IOM’s Volume 10 report reads,
“Because cancer incidence in the last 10 years has not been reported [by VA],
additional follow-up is needed.” (p.102). IOM’s Volume 10 panel was tasked with
reviewing published medical literature since the last major review six years
ago, but due to one of VA's many failures couldn't do so because this new data
hasn't been reported by VA.

However,
unlike the panel’s recommendation for additional follow-up with cancer
incidence, IOM’s Volume 10 committee instead inflicted damage when they
recommended that, “further studies to assess the increased incidence and
prevalence of circulatory, hematologic, musculoskeletal, gastrointestinal,
genitourinary, reproductive, endocrine and metabolic, respiratory, chronic
skin, and mental health conditions due to deployment in the Gulf War should not
be undertaken” (pp. 9-10).Unlike IOM panels
that are limited by VA’s “don’t look, don’t find” failures, we must not mistake
absence of VA evidence for evidence of absence of long histories of these adverse
health outcomes in Gulf War veterans.

Like the
earlier IOM reports, the Volume 10 panel found no new associations between Gulf
War exposures and adverse health outcomes.It also found no new associations between Gulf War service and ill
health.

While
recommending greater effort towards treatment and acknowledging Gulf War
Illness as the signature condition of the 1991 Gulf War, it recommended that research and treatment for Gulf War
Illness now focus on, “brain-body interconnectedness.”It also suggests focusing on “management” of
Gulf War Illness.Together, these are an apparent departure from the
optimism of the 2010 IOM report, which said, “effective treatments,
cures, and, it is hoped, preventions … can
likely be found.”

The promising new
science that is providing keys to Gulf War Illness’s underlying mechanism and
promising avenues towards treatment hasn’t shifted course since 2010, it has
just provided even greater evidence for the role of toxic exposures in Gulf War
Illness and provided increasing detail in closing in on effective
treatments.What has changed, however is
that the IOM Volume 10 panel and reviewers included some of the same people and
the same mindsets as the dark days of the 1990’s, when everything about Gulf
War veterans’ exposures and symptoms was characterized as utterly unknowable,
when Gulf War veterans’ health issues were marginalized, and when VA and DOD
officials seemed intent on restricting Gulf War Illness discussions to “stress”
causation and mental health management rather than focusing on evidence-based
treatments for Gulf War veterans’ toxic wounds.Those VA and DOD
officials denied Gulf War veterans’ toxic exposures, failed to develop
treatments or preventions, redirected Gulf War veterans away from the goal of
real healthcare, shut down research, and denied benefits.This new IOM recommendation amounts to little
more than the same tired old themes from the 1990’s – again, just when Gulf War
Illness treatment research is finally making real progress to understand the
illness and identify treatments.

As I walked
through the airport headed home following the meeting where this latest IOM
report was released, my shoulder was heavy with a bag full of past IOM Gulf War
reports.My heart was even heavier.Twenty-five years after our war, and nearly
two decades after the enactment of the 1998 laws, these IOM Gulf War reports
nearly fill a small shelf.But despite
millions of dollars and countless panel members’ work, the collective weight of
these volumes have not associated animal exposures with human health outcomes, have
found precious few health outcomes associated with Gulf War service, have not
evaluated many of the exposures listed in the 1998 laws, and have added little
toward the development of effective, evidence-based treatments for Gulf War
Illness. Together, the IOM and its VA
taskmaster have had little impact in improving the health or lives of Gulf War
veterans with Gulf War Illness or achieving the goals set forth in the 1998
Gulf War legislation.

VA/DOD CLINICAL PRACTICE GUIDELINE (CPG)

As if the
massive, multi-volume failure of Gulf War veterans wasn’t enough, VA and DoD
have now developed a highly problematic Clinical Practice Guideline for Gulf
War Illness that goes back to the darkest days of the 1990s.In this Guideline, VA and DOD lump Gulf War
Illness together with psychosomatic and other conditions that together, its
authors call,“Chronic Multisymptom
Illness” (CMI).It is worth noting that
CMI is an overly broad and inappropriate catch-all label that IOM panels have rightly
told VA to stop using for Gulf War Illness.

This Clinical
Practice Guideline is intended for all healthcare providers – DOD, VA, and
beyond.Its primary treatment
recommendations for GWI are cognitive behavioral therapy (CBT), exercise, and
psychotropic drugs.Suicidal ideation is
listed in the Guide as a known “notable adverse effect” for every single one of
those medications.

Despite public
statements by VA officials, including before this Committee, that Gulf War
Illness is not a psychological, psychiatric, or psychosomatic condition, this
VA-DoD guide specifically compares “CMI” with a group of, “similar
‘overlapping’ symptom syndromes” and “somatization disorder”.The terms “somatization disorder”, and use
the terms “somatization”, “somatization disorder”, “somatoform”, and
“somatoform disorder”, and “psychosomatic” a stunning 52 times in the
guide.The term, “hypochondriasis” is
also used and referenced.

While the
Clinical Practice Guideline authors use the term, “evidence-based”, 19 times
throughout the document in an apparent attempt to increase its credibility,
they go on to state, “treatment of CMI is as much an art as it is a science”
(p.8).

Showing its
failure to rely on scientific evidence, a growing body of promising scientific
research related to inflammatory cytokines, mitochondria and mitochondrial
dysfunction (for example), including Coenzyme Q10 as a potential therapy.Yet, the term “cytokine” and variants appear
only twice, and no reference whatsoever is made to mitochondria or word
variants.

It would seem
hard to believe, given the large body of peer-reviewed science on Gulf War
Illness that has been published in more recent years, that a DOD or VA clinical
guideline produced in 2014 would rely on the old “psychosomatic” fictions of
the 1990s or on the VA and DOD officials that championed them.What’s not surprising, however, is that the
list of people who developed this guide that relies on psychosomatic artfulness
rather than evidence-based treatments included some of the same old names from
the dark days of the 1990s.

This guide is
another example of VA’s systemic research failures.From, “Don’t look, don’t find,” to a renewed
reliance on psychosomatic explanations and “treatments” for Gulf War Illness,
the intent of the 1998 laws remain out of reach at VA past and present.

GULF WAR ILLNESS CDMRP

As
many of the members of this Committee know, despite the serious problems noted
above, there is a great deal of encouragement and hope for ill Gulf War
veterans in the science being conducted and published in recent years.Much of this promising new research is in
the treatment-focused Gulf War Illness Congressionally Directed Medical
Research Program (CDMRP), which exists outside VA or the rest of DoD thanks to
Congress, including many of the Members on this Committee.

One-third of the
studies funded through this program are testing treatments that might help
improve the health and lives of veterans with GWI.Two-thirds of the studies are aimed at Gulf
War Illness’s underlying mechanisms, including critically important animal
studies that test exposures and measure health outcomes, identify treatment
targets, and test treatments.

Three
CDMRP-funded treatment studies have already shown promise in reducing certain
GWI symptoms, including Coenzyme Q10, Carnosine, and acupuncture.Others have found powerful links between Gulf
War toxic exposures and adverse health outcomes and are helping pave the way
for treatment development.

The vast
majority of this research is still in the pipeline. However, this
powerfully encouraging progress could be at risk, by the IOM Volume 10 recommendations
and by another IOM panel aimed at all the CDMRPs that is chaired and directed
by some of the same former VA and DOD officials of the 1990s who have done so
much harm to Gulf War veterans.

CONCLUSIONS

If we measure
VA’s success by how it has improved Gulf War veterans’ health twenty-five years
after the war, VA still has no evidence-based treatments for Gulf War
Illness.VA has circumvented or ignored
most of the aims of the 1998 laws.Instead,
some of those same old VA and DOD officials from the dark days of the 1990s have
joined together in their usual old cabal and are once again pushing
long-discredited theories of psychosomatic causation and “treatment” in new and
potentially influential ways.

In twenty-five
years, VA has made little progress on Gulf War Illness, and now appears to be
working to roll back the clock to the dark days of the 1990’s.

§Instead of
following recommendations on Gulf War Illness research that would lead to
improving ill Gulf War veterans’ health and lives, VA eliminated the
Research Advisory Committee’s (RAC) ability to
evaluate the effectiveness of all federal Gulf War research efforts, limited
its scope from all federal research to just VA’s, eliminated its treatment
focus mandate, and more.

§VA admitted to “losing” its
registry for Gulf War spouses and children. It is unclear what VA has done to
recover that data.

§VA continues make
reports to Congress that inflate “Gulf War research” spending by including
studies that are not specific to Gulf War veterans.

§VA has the authority to
develop new presumptives for these ill and suffering veterans, but unlike with
Agent Orange, has failed to identify any new conditions beyond a set of rare
endemic infectious diseases that affect almost no one.

§IOM’s latest report,
shaped by VA’s contract, argues that individual Gulf War exposures are forever
unknowable.We knew that when seeking
the 1998 legislation, aimed at connecting generic exposure data with health
outcomes.VA has stymied those efforts.

§VA has not linked a
single adverse health outcome to any Gulf War exposures nor created a single
new presumptive condition under the 1998 laws to help suffering veterans beyond
the largely irrelevant endemic infections noted earlier.

Twenty-five
years later, one-fourth to one-third of us Gulf War veterans continue to struggle
with the health and life effects of Gulf War Illness.Others among us have died of ALS, brain
cancer, other diseases, suicide.Yet VA,
with the aid of DoD and the complicity of the IOM, has made little progress in
developing evidence-based treatments or improving the health and lives of
veterans suffering from signature injury of the 1991 Gulf War – Gulf War
Illness.

Twenty-five
years later, ill Gulf War veterans are still in pain.They are suffering.They have been begging for help for years and
years.Twenty-five years later, Gulf War
veterans are battling against VA and DOD bureaucrats, including some of the
very same ones who fought against the 1998 laws in the first place.

We must not
continue to allow VA and DoD to substitute “risk communication” for
evidence-based healthcare, psychosomatic drugs for treatment-focused research,
spin for substance, or “Don’t look, don’t find” for the objective collection,
analysis, and reporting of deployment health outcomes.The letter, the spirit, and the intent of the
1998 Persian Gulf War laws have yet to be achieved.

On this 25th
anniversary of the war, our Gulf War veterans deserve the best that modern
science and the U.S. government can offer to improve their health and
lives.Mr. Chairman, as one of us Gulf
War veterans, and Members of this powerful Committee, please join together with
your colleagues on both sides of the aisle and in both houses and help fix these
serious issues, once and for all.

About 91outcomes

91outcomes.com is a health and news website for veterans of the 1991 Gulf War.

The health outcomes of the 1991 Gulf War continue to profoundly affect between one-fourth and one-third, according to official estimates, of the war’s nearly 700,000 U.S. veterans.

They also affect innumerable fellow veterans from our Coalition partners, including the UK, Australia, Canada, and the Czech Republic, to name just a few.

The aim of 91outcomes.com is to provide fellow Gulf War veterans and their caregivers, advocates, and loved ones, with a credible source of information for health information on Gulf War Illness and other news, all in one place, some of which isn't available anywhere else.

***

About Me

Allow me to introduce myself. I'm Anthony Hardie, the publisher and editor of 91outcomes.com. I created 91outcomes.com in 2009** because I'm also one of the 250,000 veterans of the 1991 Gulf War afflicted by Gulf War Illness, and this is what I choose to do to help my fellow Gulf War veterans. Of course, there's much more that remains to be done -- please feel free to jump in and help however you may see fit to fill those many gaps.

I've been continuously active as a national advocate on Gulf War and other veterans' issues since 1995, shortly after my honorable discharge after seven years of U.S. Army service that included serving in the 1991 Gulf War and Somalia. Later, in part because of that advocacy work, I was selected to be a Congressional aide, and then a veterans’ affairs state agency executive. If you're really interested, you can read more about me on my Google profile.

I also do my best to to help my fellow Gulf War veterans by serving as an affected veteran on the programmatic panel that leads and guides theGulf War Illness Research Program, part of the Congressionally Directed Medical Research Programs (CDMRP). And, I'm a former longtime member of VA's Research Advisory Committee on Gulf War Veterans' Illnesses (RAC) and the VA’s Gulf War Illness [Research] Steering Committee. In my service on these panels, I do my very best to represent the many other ill and affected Gulf War veterans, including the readers of this website.

**NOTE: Much of the content on 91outcomes is "fair use" content archived for personal use and for single-site archival use by other Gulf War veterans. Articles dated prior to 2009 are archival in nature, and are pre-dated concurrent to the time noted in the article.

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Depleted Uranium (DU) in the Gulf

Disclaimer

The content contained herein was not prepared by medical professionals and it is not intended, nor should it be considered, as a substitute for medical advice.

The information provided on this website is intended as educational material, designed solely to support, and not replace, the relationship that exists between a patient/site visitor and his/her healthcare professional.

The material contained herein is general in nature and may not apply to your particular factual or legal circumstances.

Online readers should not act on this information without seeking professional counsel and advice.